Individual
JUAN ALEXANDER ALONSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS,LAT,ATC
Contact information
Practice address
482 BLACKSHEAR HWY, BAXLEY, GA 31513-6708
(912) 367-8610
(912) 366-9877
Mailing address
1258 SUNSET BLVD APT 1F, JESUP, GA 31545-7802
(404) 434-2171
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT002830
GA
Other
Enumeration date
03/04/2019
Last updated
03/04/2019
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